The profiles of neuropsychological deficits associated with Alzheimer's disease (AD) in Young-Old (M age < 70) and Very-Old (M age > 80) patients were compared, along with possible modifying effects of apolipoprotein E (APOE) genotype on these profiles. A comprehensive battery of neuropsychological tests was administered to the two AD patient groups (Young-Old: n = 33; Very-Old: n = 48) and their respective age-matched normal control (NC) groups who remained free of dementia on follow-up examinations over a 1 to 10 year period (Young-Old: n = 43; Very-Old: n = 36). AD and NC groups did not differ in education levels or gender distributions. Young-Old AD and Very-Old AD groups were comparable in education, gender, dementia severity, and disease duration. Results showed that both AD groups achieved comparable raw scores on all the neuropsychological measures. However, when scores were standardized on the basis of performance of their respective NC groups (i.e., age-corrected z scores), Very-Old AD patients significantly outperformed Young-Old AD patients on tests of executive functions, visuospatial skills, and delayed memory. Furthermore, the relationship between age and memory and executive function deficits in AD was modified by APOE genotype. These data suggest that the profile of neuropsychological deficits associated with AD in the Very-Old lacks the disproportionate saliency of episodic memory and executive function deficits typical of the Young-Old. (JINS, 2003, 9, 783–795.)

Deficits in visual-spatial ability can be associated with Parkinson's disease (PD), and there are several possible reasons for these deficits. Dysfunction in frontal–striatal and/or frontal–parietal systems, associated with dopamine deficiency, might disrupt cognitive processes either supporting (e.g., working memory) or subserving visual-spatial computations. The goal of this study was to assess visual–spatial orientation ability in individuals with PD using the Mental Rotations Test (MRT), along with other measures of cognitive function. Non-demented men with PD were significantly less accurate on this test than matched control men. In contrast, women with PD performed similarly to matched control women, but both groups of women did not perform much better than chance. Further, mental rotation accuracy in men correlated with their executive skills involving mental processing and psychomotor speed. In women with PD, however, mental rotation accuracy correlated negatively with verbal memory, indicating that higher mental rotation performance was associated with lower ability in verbal memory. These results indicate that PD is associated with visual–spatial orientation deficits in men. Women with PD and control women both performed poorly on the MRT, possibly reflecting a floor effect. Although men and women with PD appear to engage different cognitive processes in this task, the reason for the sex difference remains to be elucidated. (JINS, 2003, 9, 1078–1087.)

Age and gender effects on verbal episodic memory are well established. However, the possibility of interactions between age and gender has been raised by studies linking estrogen and verbal memory performance, and by research suggesting gender differences in age-related cortical atrophy. We evaluated whether age by gender interactions in verbal memory were present. Subjects within three years of the median age of menopause were excluded from a large cohort of normal subjects, resulting in a younger sample (16–47 years) of 288 men and 285 women, and an older sample (55–89 years) of 201 men and 245 women. All subjects were administered the CVLT-2, a multiple-trial list-learning task. Verbal memory was negatively correlated with age for younger men, older men, and older women, but not for younger women. Multivariate analyses indicated age by gender interactions on memory for the younger group but not the older group. Results indicate that verbal memory declines with age for younger men but not younger women, whereas both older men and older women show age-related declines. These findings are consistent with hypotheses linking estrogen and verbal memory performance, and with imaging data suggesting that age-related hippocampal atrophy is found in younger men but not younger women. The role of estrogen on cognition in normal aging warrants further study. (JINS, 2003, 9, 97–102.)

Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) can produce a higher incidence of neuropsychological complications than other types of highly invasive noncardiac vascular surgery. Cognitive complications most likely arise from either embolization or hypoxia. An alternative surgical procedure has been developed that allows CABG to be performed without stopping the heart (“off-pump” CABG, or OPCABG). This study examined the neuropsychological performance of patients undergoing OPCABG, hypothesizing that patients undergoing OPCABG would show fewer cognitive deficits than patients whose hearts were stopped. A 1-hr neuropsychological battery was administered preoperatively to 43 patients before prospective randomization to either CPB CABG or OPCABG, and again to 34 of those patients 2 to 3 months postoperatively by an examiner blind to surgical condition. Neuropsychological status did not change 2.5 months postsurgically in either OPCABG or CABG groups. However, both groups showed dramatic presurgical cognitive deficits in multiple domains, particularly verbal memory and psychomotor speed. This corroborates previous research suggesting that patients requiring CABG surgery may evidence significant presurgical cognitive deficits as a result of existing vascular disease. (JINS, 2003, 9, 913–924.)

Poor awareness of deficit is common after brain injury. Recent literature has examined various tools for measurement of this phenomenon; the most widely used being self–other rating scales. Although self–other scale measures have face validity, their criterion-related validity has not been adequately demonstrated, and there is little information as to whether and how they relate to other neuropsychological measures. The present study compared measurement of awareness by the Dysexecutive (DEX) Questionnaire self–other rating scale with the Self-Awareness of Deficits Interview (SADI), a semistructured interview measure. Evaluation of awareness by these measures was compared to tests of executive functioning and IQ. Results indicated significant, albeit marginal relationships between the two measures, and better correlation of the SADI with measures of frontal lobe functioning. The SADI also predicted injury severity. (JINS, 2003, 9, 450–458.)

The very high sensitivity and specificity of odor identification tasks in discriminating between Alzheimer's patients and normals suggests that they reflect the presence of underlying neuropathology. Significant neuropathological changes are seen in areas critical to processing olfactory information, even in the early stages of Alzheimer's disease (AD). The current study was designed to investigate whether performance on olfactory tasks (odor threshold and odor identification) was related to volumetric MRI measures of mesial temporal areas central to olfactory information processing and important in the neuropathology of AD. Participants were 8 male and 5 female patients with probable AD, and 10 male and 12 female normal age-matched controls, diagnosed at the UCSD Alzheimer's Disease Research Center. The study investigated correlations between volumetric measures of hippocampus, the parahippocampal gyrus and the amygdala, and the psychophysical measures of olfactory function. Robust relationships were observed between mesial temporal lobe volumes and olfactory functional measures. The finding of a strong relationship between left hippocampal volume and performance on the odor identification task (r = .85) is compatible with a left-hemisphere superiority for verbally mediated olfactory tasks. The findings suggest a neural substrate for the breakdown in functional performance on verbally mediated odor identification tasks in Alzheimer's disease and suggest the utility of quantitative MRI measures and psychophysical performance in the assessment of AD. These results support the potential clinical utility of inclusion of odor identification tests in diagnostic batteries for detecting AD. (JINS, 2003, 9, 459–471.)

The exact role of the basal ganglia in both the motor and non-motor domains has proven elusive since it is virtually impossible to refer to its function in isolation of cortical, and especially frontal cortical circuits. The result is that we often speak of frontal-striatal circuits and functions but this still leaves us in the dark when trying to specify basal ganglia information processing. A critical review of the data from both basic science and clinical studies suggests that we should break down processing along a temporal continuum, including the domains of context, sequential information processing, and feedback or reinforcement (i.e., the consequences of action). This analysis would cut across other theoretical constructs, such as attention, central executive, memory, and learning functions, traditionally employed in the neuropsychological literature. Under specified behavioral constraint, the basal ganglia can then be seen to be involved in fundamental aspects of attentional control (often covert), in the guidance of the early stages of learning (especially reinforcement-based, but also encoding strategies in explicit paradigms), and in the associative binding of reward to cue salience and response sequences via dopaminergic mechanisms. Parkinson’s disease is considered to offer only a limited view of basal ganglia function due to partial striatal depletion of dopamine and the potential involvement of other structures and transmitters in its pathology. It is hoped that the present formulation will suggest new heuristic research strategies for basal ganglia research, permitting a closer link to be established between neurophysiological, functional imaging and neuropsychological paradigms. (JINS, 2003, 9, 103–127.)

Findings of category-specific impairments have suggested that human semantic memory may be organized around a living/nonliving dichotomy. In order to assess implicit memory performance for living and nonliving concepts, one group of neurologically intact individuals participated in a cross-form conceptual priming paradigm. In Block 1, pictures primed words while in Block 2 words were used to prime pictures. Across all phases of the experiment, subjects decided whether items represented something which was living or nonliving, and response times were recorded. Results revealed greater priming for living concepts across both blocks. Greater priming for living concepts may have occurred because of increased or prolonged conceptual activation of these concepts. Results are discussed in the context of theoretical accounts of the category-specific impairments observed in brain-damaged populations. (JINS, 2003, 9, 796–805.)

Studies involving brain-lesioned subjects have used the paced finger tapping (PFT) task to investigate the neural systems that govern motor timing. Patients with Parkinson's disease (PD), for example, demonstrate abnormal performance on the PFT, characterized by decreased accuracy and variability changes, suggesting that the basal ganglia may play a critical role in motor timing. Consistent with this hypothesis, an fMRI study of healthy participants demonstrated that the medial frontostriatal circuit (dorsal putamen, ventrolateral thalamus, SMA) correlated with explicit time-dependent components of the PFT task. In the current fMRI study, PD patients and healthy age-matched controls were imaged while performing the PFT. PD patients underwent 2 imaging sessions, 1 on and the other off dopamine supplementation. Relative to controls, PD patients were less accurate and showed greater variability on the PFT task relative to controls. No PFT performance differences were observed between the on and off medication states despite significantly greater motor symptoms on the Unified Parkinson's Disease Rating Scale (UPDRS) in the off medication state. Functional imaging results demonstrated decreased activation within the sensorimotor cortex (SMC), cerebellum, and medial premotor system in the PD patients compared to controls. With dopamine replacement, an increase in the spatial extent of activation was observed within the SMC, SMA, and putamen in the PD patients. These results indicate that impaired timing reproduction in PD patients is associated with reduced brain activation within motor and medial premotor circuits. Despite a lack of improvement in PFT performance, PD patient's brain activation patterns were partially “normalized” with dopamine supplementation. These findings could not be attributed to greater head movement artifacts or basal ganglia atrophy within the PD group. (JINS, 2003, 9, 1088–1098.)

Wilson and Watson (1996) identified several factors that were associated with use of memory aids and strategies in a group of people with acquired brain injury. The present study tested these findings, with the aim of identifying the variables that best predict effective use of memory aids after brain injury. One-hundred and one people with memory problems arising from brain injury and their carers were interviewed to identify the aids/strategies used to compensate for memory impairment, and the efficacy of their use. Information relating to variables previously found, or hypothesized to predict use of memory aids, was collected. Use of memory aids correlated with level of independence. External aids such as calendars, wall charts, and notebooks were the most commonly used memory aids. Electronic organizers were not used by many participants. The variables that best predicted use of memory aids were (1) current age, (2) time since injury, (3) number of aids used premorbidly, and (4) a measure of attentional functioning. The implications for rehabilitation services are discussed. (JINS, 2003, 9, 925–935.)

Qualitative and quantitative performance on the Halstead Finger Tapping test may help differentiate brain dysfunctional patients from normal controls. “Normal” and “abnormal” finger tapping patterns during this task have been characterized and illustrated pictorially. Data from 65 patients with traumatic brain injury (TBI) and 15 normal controls support the dual proposition that (1) abnormal finger tapping patterns are more commonly observed in TBI patients than in controls and (2) the frequency of abnormal finger movements may relate to the severity of TBI during the acute stages after trauma. Future prospective studies are needed to replicate these findings. (JINS, 2003, 9, 128–133.)

In From Hand to Mouth: The Origins of Language Michael Corballis provides an engaging, highly readable and provocative account of the evolution of human language. The primary thesis of his book is that language evolved from manual and facial gestures rather than from animal vocalizations, as is often assumed. While this point of view has been expressed by others during the last few centuries (for example, Condillac in 1747), it has never been argued more forcefully and with as much supporting scholarly evidence. (I suspect that it has also never been argued with greater use of hand/mouth adages, clichés and puns.) Among the more provocative ideas is the suggestion that human speech, like writing, was a cultural invention subsequent to gestural language rather than the evolutionary essence of language.

For nearly a century, the primary method employed by psychologists to define and test the validity of constructs evaluated by assessment instruments has been shared-variance techniques such as intervariable correlations or factor analysis with large normative or mixed clinical samples. To illustrate the shortcomings of this approach, we conducted (1) correlational analyses of immediate- and delayed-memory measures separately in normal participants and in homogeneous samples of patients with either Alzheimer's disease or Huntington's disease; and (2) factor analysis of immediate and delayed-recall and recognition measures in a large, homogeneous sample of patients with Alzheimer's disease. The findings revealed that cognitive measures that share variance in the intact brain—thereby giving the facade of assessing a unitary construct—can dissociate and contribute to unique variance in the damaged brain, but only if the pathology occurs in brain regions known to disrupt vital cognitive processes tapped by those measures. The results illustrate that shared-variance procedures applied to normal or mixed clinical populations can mask some of the most vital cognitive constructs, such as the classic distinction between short- and long-term memory. Implications of these findings for research and clinical practice are discussed. (JINS, 2003, 9, 936–946.)

We present the case of a 23-year-old Vietnamese male with a 2-year history of a psychotic illness marked by prominent negative symptoms, fatuousness and disturbed behavior. Neuroimaging revealed a prominent vascular flow void affecting the middle and anterior cerebral arteries, with associated increased collateral supply to the frontal cortex, consistent with Moyamoya disease. Neurological examination was unremarkable; however, neuropsychological assessment revealed significant executive dysfunction, including stimulus-driven behavior. Whilst the diagnosis of schizophrenia and Moyamoya disease may be coincidental, an interaction between the 2 diseases may have led to some of the atypical features of this case, including prominent executive dysfunction and marked sensitivity to psychotropic medication. We discuss the nature of possible interactions between the 2 conditions. This case also highlights the importance of re-evaluating patients with atypical or treatment-resistant psychoses for cerebral pathology. (JINS, 2003, 9, 806–810.)

Within the last decade, various applications of two-way audio-visual telecommunication have been implemented in the Norwegian health care system to facilitate the delivery of medical services to patients located in rural areas away from the hospitals. This technology may also be useful to extend neuropsychological services to underserved areas and thereby reduce the patients' travel time and costs. In the current study, a total of 12 visual, verbal and performance tests were administered face-to-face and via videophones to 32 volunteer participants to examine the consistency and stability of test-scores when delivered via different formats. The obtained reliability coefficients ranged from .37 to .86 with a median value of .74. When testing for mean differences, the measures on verbal learning (WMS–Logical Memory I) and auditory attention (Seashore Rhythm Test) differed significantly due to administration format (t = 2.34, p = .024 and t = 2.37, p = .025, respectively). The findings imply that administration format does not appear to affect the reliability of measurement but neuropsychological test performance is significantly higher for the measures of attention and memory when delivered via videophone. Additional research on these cognitive domains is required, and if the observed differences due to testing format persist, separate normative data via telecommunication will be required before assessments are carried out. Also, since only normal participants were included in this study, the findings may have external validity for normal populations, but similar controlled trials with patients need to be completed before remote assessments can be implemented in regular clinical practice. (JINS, 2003, 9, 472–478.)

The author states that this book was written for a target audience of school psychologists, child psychologists, and educators. The intent of the book is to provide this audience with a knowledge base for traumatic brain injury, including basic neuroanatomy, sequelae of TBI, assessment practices, family issues, and interventions. One may presume from various hints that the author's primary purpose, in fact, is to provide school psychologists with the know-how to provide much-needed services to the students in their schools who do not have access to pediatric neuropsychologists. With this goal in mind, the menu includes an appetizer of neuroanatomy, a first course of assessment tools, and a second course of school reintegration and intervention strategies.

The Journal of the International Neuropsychological Society published recently a paper that should become influential shortly. However, given its potential impact, this study has to be examined carefully.

This commentary expands on issues raised by Delis, Jacobson, Bondi, Hamilton, and Salmon, in their paper on the use of shared variance techniques to establish construct validity. Significant discussion is focused on method variance, and how this can distort the results of factor analysis. Solutions are offered for the appropriate use of factor analysis in construct validation. Examples are also provided of construct validation procedures that do not rely on correlational or shared variance techniques. (JINS, 2003, 9, 947–953.)

The following is a correction for an error that occurred in the Journal of the International Neuropsychological Society, Vol. 9, No. 1. The Critical Review titled “Frontal-striatal Circuit Functions: Context, Sequence, and Consequence” by Jean A. Saint-Cyr had two lines of copy accidentally omitted at the bottom of the second column on page 103.

This 27-chapter volume arose from a symposium held in Lyon, France, in June of 1999, that sought to integrate information from academic scientific studies of olfaction, largely psychological in nature, with knowledge derived from the perfume industry. It is dedicated to the French perfumer Edmond Roudnitska, known for creating such classic fragrances as “Femme” (1944, Rochas), “Diorama” (1948, Dior), L'Eau” (1951, Hermès), “Diorissimo” (1956, Dior), “Eau Savage” (1966, Dior), and “Diorella” (1972, Dior), and addresses such topics as odor classification, odor memory, odor conditioning, and the plasticity of chemosensation.